Introduction: There is large amount of data on the prevalence and risk factors of speech and language delay in children up to three years of age, but the data from three to six years of age group is very limited.

Aim:To assess the speech and language delay in children from birth to six years of age and its association with environmental and biological risk factors.

Materials and Methods: A total of 400 children aged zero to six years attending well baby clinics and daily paediatrics outpatient department for routine check-up and immunization were evaluated using Language Evaluation Scale Trivandrum (LEST) zero to three and three to six. The prevalence and the association with risk factors in each age group was calculated and analysed using SPSS version 18.0. Chi-square test and Fisher's exact test were used in the statistical analysis.

Results: Language delay was seen in 38 (9.5%) children among the 400 children studied. The children of age group 49 to 60 months (p-value 0.839) and male gender (p-value 0.923) showed more delay but statistically not significant. Among the various environmental factors studied, second born child Odds Ratio (OR-3.5), children who were not single in family (OR-1.9) and children not living together with their both parents (OR-4.3) showed significant association. The biological risk factors like preterm children (OR-3.11), babies who were born of caesarean section(OR-3.9), who had significant birth history (OR-11.1) and those who were not exclusively breast fed (OR-4.4) showed significant association.

Conclusion: A nurturing home environment with exclusive breast feeding and harmony in family in early years of life help a lot in achieving language skill.